Interactive communciation system for medical treatment of remotely located patients

ABSTRACT

A system for providing medical services to a patient at a location remote to a medical practitioner comprises a patient&#39;s station and a medical practitioner&#39;s station in communication with each other. Both stations are equipped with video and audio capability allowing both the practitioner and patient to see and hear one another. A variety of devices are present at both stations that enable the transmission of information between the parties. Several monitors, located at the patient&#39;s station, enable the practitioner to measure and monitor several health related parameters. A camera is mounted in the patient&#39;s station in front of a frame that holds the patient&#39;s driver&#39;s license or other forms of identification. Images of the patient&#39;s identifying documents are transmitted to the medical practitioner station to allow positive identification. Payment for medical services rendered is accomplished by using a credit card reader in the patient&#39;s station, supplying an accepted insurance card, or by obtaining an account number from the retailer who on whose premises the patient&#39;s station is located.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to diagnosis and treatment ofpatients. More particularly, the present invention is a system forenabling medical treatment to be given to a patient at a remote locationby a medical practitioner from a central location.

2. Discussion of Background

Not all patients that visit the hospital or their doctor's office are inneed of highly specialized medical care. Many times, a patient needsonly general medical advice or a prescription for medication to treat acommon cold, a minor rash, or simple infection. In many instances, apatient must schedule a visit to the doctor for nothing more than therenewal of a prescription.

The necessity of scheduling a doctor's appointment and visiting theoffice during normal working hours is an inconvenience to the patientwho must leave work to see the doctor. This inconvenience is compoundedby the long waiting periods often encountered in doctors' offices.Often, due to these inconveniences, the patient will forgo seekingmedical attention for minor ailments. Unfortunately, if not properlytreated, many minor ailments will grow into serious medical problemsthat require immediate, and costly, medical attention.

Consequently, there exists a need for a medical communications systemwhich can deliver basic medical care in a cost efficient manner.

SUMMARY OF THE INVENTION

According to its major aspects and briefly stated, the present inventionis an interactive communication system enabling a doctor or other healthcare workers at a central station to provide basic medical attention toa patient at a remote station in another location. The communicationssystem comprises a remote station, normally the patient's station, and acentral or medical practitioner's station. The term "patient," as usedherein, broadly means any individual that is in need of medicalattention while the term "medical practitioner" means a physician,nurse, pharmacist or other medical practitioner trained and licensed forproviding the medical service performed using the present system. Itwill be clear that higher levels of service may be provided by medicalpractitioners who meet the necessary qualifications for providing thatservice.

The first station is equipped with a video camera and two videoterminals, or one video terminal with several images simultaneouslydisplayed. The first terminal displays a live video image of the medicalpractitioner. The second terminal displays the patient so he or she cansee the image that is being transmitted. Both remote and centralstations contain a speaker and a microphone. Alternatively or inaddition, telephone headsets are provided, allowing private conversationbetween the practitioner and patient.

To enable sending and receiving text, a computer keyboard and screen,and a facsimile machine are located in each station. Other types ofinput devices, such as a mouse for control of the position of the cursoror pointer present on the screen or a touch screen technology can beused as well. A variety of diagnostic devices are also present at thepatient's station for measuring and monitoring health parameters such astemperature, heart rate, and blood pressure.

An additional camera, located within the interior of the patient'sstation, is directed towards a frame recessed in the station wall. Theframe is dimensioned to receive an insurance card, driver's license orother identification cards of similar dimension. The video image of thecard is converted to a still image by a video camera or a scanner andtransmitted to the central station. As a result, the practitioner at thecentral station can verify the identity of the patient requestingmedical attention by comparing the picture on the identification card orthe number on an insurance card to records available to the medicalpractitioner. More sophisticated identification techniques can be usedin lieu of these or in addition to these.

Establishing a mode of payment for services rendered can be accomplishedin several ways. First, the patient may already have established anaccount with the medical practitioner and, by simply requesting a billagainst that account, the arrangements are complete. If there is noexisting arrangement, the patient may pay by credit (or debit) card. Inthe remote station, a credit card reader and an electronic signaturedevice are housed for the reading of credit card information and signingan electronic receipt. Alternatively, if the remote station is locatedat a pharmacy or other place where the owner of the premises can providecredit to the patient, the patient may charge its bill to an accountnumber provided by the owner. Upon conclusion of the session betweenpractitioner and patient, an itemized bill would be forwarded to thepatient's station by facsimile. A monthly statement of services renderedfrom that station would be mailed to the owner of the premises.Additionally, patient's could pay using a HMO, PPO, or similar healthmanagement program card. With this mode of payment, the card is placedwithin the frame while its image is forwarded to the practitioner'sstation, as discussed above.

Each station is controlled by a central processing unit (CPU).Audio/video signals and data are transmitted between stations usingestablished telecommunication methods and systems, including radio ormicrowave transmission to distant receivers, perhaps via satellites, andmodems in combination with telephone lines or fiber optic cables.

The patient's station may be installed in any pharmacy, drugstore orlarge supermarkets having a pharmacy. Additionally, the station may alsobe located in airports, malls, or corporations which seek to provide onsite medical attention for their employees. Moreover, many hospitalswill install a station to allow sophisticated diagnoses of patients byspecialists located in distant cities. With a station located at a smallclinic, manned only by a nurse trained to provide routine health care,such as the administration of inoculations, for example, assisted by adoctor at the remote station, health care can be provided to those insmall communities or rural areas more efficiently.

The incorporation of devices which make possible both the positiveidentification of the patient and a method of payment for medicalservices rendered is an important feature of the present invention.Although the importance of proper identification of a patient fortreatment purposes will be clear, the importance of patentidentification for securing payment and the need to have some way ofsecuring payment cannot be disregarded. Medical services are expensive,and patients are expected to pay for them. By providing for these, thepresent invention enables remote, interactive providing of medicalservices to be given in a variety of important circumstances, rangingfrom diagnosis of simple ailments to customers at a pharmacy, to makingsophisticated diagnosis of a patient located in another city.Furthermore, these services can be provided at much lower cost thanpresently because they eliminate much of the inefficiency of the presentsystem.

Establishing a two way interactive communication capability is anotherfeature of the present invention. This capability eliminates the needfor the patient to be literally "face to face" with the medicalpractitioner for medical services to be rendered. As a result,substantial savings can be realized by both practitioner and patient.Patients whose ailments are simple can be quickly diagnosed, at allhours of the day, without having to take the time to go to the doctor'soffice or hospital. Moreover, the use of doctors' time can be maximizedbecause they can examine and treat a series of patients in rapidsuccession from one location. Furthermore, in rural areas that areunderserved by doctors, patients often allow medical conditions to gountreated because of the difficulty and inconvenience in traveling longdistances in order to obtain medical attention. The present inventioncan be used to set up a series of satellite clinics, enabling doctors atdistant locations to provide much needed medical care.

The ability to measure and monitor a variety of different medicalvariables is still another feature of the present invention. Bymonitoring such variables it is possible to make a more accuratediagnosis of the patient. In addition, as technology develops, new, lessinvasive, methods and apparatus for analyzing physical and chemicalaspects of the body that impact health, such apparatus may beincorporated into the present invention. For example, sound waves can bepassed through the body and the echoes analyzed in lieu of the currentsubjective technique of palpation. Consequently, more sophisticated andwide ranging diagnosis can be made.

Other features and their advantages will be apparent to those skilled inthe art from a careful reading of the Detailed Description of PreferredEmbodiments accompanied by the following drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings,

FIG. 1 is a front view of a medical communications system according to apreferred embodiment of the present invention; and

FIG. 2 is a flow chart depicting the major steps of a medicalcommunication system according to a preferred embodiment of the presentinvention.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

The present invention is a medical communications system that enablesmedical care to be given by a medical practitioner present at a centralstation to a patient present at a remote location. The present inventionallows the two to communicate live, seeing and hearing each other, andto transmit information and data for the diagnosis and treatment of thepatient's condition without the need for face-to-face examination.Additionally, the system incorporates technology to allow positiveidentification of the patient, and establishment of a mode of paymentfor services rendered.

Referring now to FIG. 1., there is shown a medical communications systemaccording to a preferred embodiment of the present invention, generallydesignated by reference numeral 10. System 10 is comprised of a remote,or patient's station 20, remotely located from a central orpractitioner's station 100. Stations 20 and 100 are electronicallyconnected via communications link 150. Each station 20 and 100 isequipped with a central processing unit 22 and 102 respectively, whichcontrols the instructions, provides the software, and manages the datatransmission between station 20 and station 100. To provide increasedprivacy patient's station 20 may be enclosed in a booth (not shown).

To enable video conferencing between the practitioner and patient, bothstation 20 and 100 contain a video camera 24, 104, a pair of videoterminals, 26, 28 and 106, 108. Alternatively, a simple video terminalcapable of displaying multiple images using standard split screentechnology can be substituted. In each station, one video terminal (26and 106) displays the individual present at the opposing station. Theother terminal (28 and 108) displays the individual seated within thestation. Consequently, each individual is capable of viewing the videoimage of themselves that is being conveyed to the opposing station.Obviously, having only one monitor, limited to seeing the party on theother end would be possible even without split screen; however, forfeedback as to what the other party is seeing, the preferred embodimentof the present invention includes two monitors. Audio communication isaccomplished by microphones 30 and 110 and speakers 32 and 112, enablingthe practitioner and patient to talk freely. Alternatively, telephonesreceivers 34 and 114 can be used to permit more private conversationbetween the two participants.

Textual information between the parties is conveyed using computerkeyboards 36, 116 and their dedicated terminals 38, 118. Electroniccursor directors 40 and 120, commonly referred to as a "mouse" arepresent at both stations 20 and 100 to further facilitate the transferof information between the parties. CPU's 22 and 102 control theoperation of keyboard, mouse and dedicated terminals at their respectivelocations.

Station 20 is also equipped with a printer 42 and a facsimile machine44. Station 100 need only have a facsimile machine 122. Printer 42enables the patient to receive prescriptions, and itemized billstatements generated by the medical practitioner located in station 100.Patient history forms, and other written information is conveyed usingfacsimile machines 44 and 122. Located in practitioner's station 100 isa video recorder 124 that records the session between the patient anddoctor for future reference, auditing and security purposes.

Patient's station 20 is equipped with a variety of diagnostic devicesthat measure and monitor parameters related to health that aid themedical practitioner in making an accurate diagnosis of the patient.Representative of these diagnostic tools include a blood pressuremonitor 46, a thermometer 48, and a heart rate monitor 50. It isrecognized that other diagnostic tools could be incorporated withinstation 20 without departing from the spirit and scope of the presentinvention. Such tools include, but are not limited to, devices thatmeasure one's weight, respiratory rate, and oximetry conditions. Datagathered from blood pressure monitor 46, thermometer 48, and heart ratemonitor 50 is displayed on terminal 118 in station 100. An adjustablelight 52, located in station 20 is controlled by the practitioner instation 100 via keyboard 118. Adjustable light 52 permits thepractitioner to focus light upon areas of the patient that require moreattention, such as the mouth or ears. Preferably the physician at thepractitioner's station 100 would also have the capability to "zoom" thelens of the video camera 24 onto the patient for closer examination.

To ensure the identity of the patient who seeks medical attention,station 20 is equipped with a frame 54 dimensioned to receive aninsurance card, driver's license or other types of identification cardshaving similar dimensions. Frame 54 which extends a slight distance fromfront wall 56. Recessed within station 20 and directed towards frame 54is a video camera 58. A patient desiring treatment will be requested toshow proof of identity. At that time, the patient will insert anidentification card within frame 54. Video camera 58, or alternatively ascanner, will then create a video image of the identification cardplaced within frame 54. The video image is then converted to a stillimage by CPU 22, using conversion techniques commonly employed in theart. Thereafter, the still image is transmitted to station 100 viacommunications link 150 and displayed on terminal 118.

After identification is established, the patient is requested to selecta mode of payment. At this point there are several alternativesavailable to the patient. If the patient has health insurance or is amember of a health management organization, and wishes to pay throughthat organization or insurance company, proof of membership in the formof a card is placed within frame 54 as detailed above. The informationdetailed on that card will be forwarded to practitioner's station 100where it will be further processed. Alternatively, the patient may wishto pay using a credit card. To accommodate this mode of payment, station20 is equipped with a credit card machine 60 and electronic signaturedevice 62. With this option, a patient runs the credit card throughmachine 60. Credit data collected from the card is transmitted topractitioner's station 100. Prior to the end of the session, thepractitioner will transmit an itemized bill which will appear onterminal 38 of practitioner's station 100. If the patient agrees withthe charges, the patient signs the bill using electronic signaturedevice 62. Thereafter, a paper copy of the bill is sent to station 20via printer 42.

Another mode of payment which may be used by the patient to pay forservices rendered is as follows: The manager or owner of the premiseswhere patient's station 20 is located, such as a pharmacy, for a fee,will provide the patient with an account or voucher number prior to theinitiation of services with the medical practitioner. Upon requestingthe attention of the practitioner, the patient will be prompted to inputthe account number using keyboard 36. After services have been rendered,the retailer or owner is billed under the given account number.

Communications link 150, which provides the connection between station20 and station 100 may be any system normally employed within the art ofcommunication networking which is capable of simultaneously transmittingdata, video and audio signals between station 20 and station 100. Suchcommunications links include, but are not limited to, data modems andstandard or dedicated telephone lines, fiber optic cable transmission,satellite transmission, or a combination thereof.

Turning now to FIG. 2 there is shown a flow chart depicting the majorsteps that occur during a session between patient and practitioner usingmedical communication system 10. Activation of patient station 20 ismade by requesting services of the medical practitioner. Once a requestfor services has been made, the patient will be prompted by a messageappearing on terminal 38 to insert an identification card within frame54. Thereafter, the patient will be requested to choose a form ofpayment. As detailed above, the patient may choose to pay via a creditcard, insurance program or by a prepaid account number. Once a mode ofpayment is established, terminal 38, driven by CPU 22 will "interview"the patient by asking preliminary questions that facilitate an accuratediagnosis. Once these questions are completed, video and auditoryconnections between station 20 and 100 are initiated. The patient willthen be requested to validate the answers to the previously askedquestions. This is accomplished using electronic signature device 62. Inlieu of a computer prompted questionnaire, the patient may be asked thesame preliminary questions by a nurse or other medical assistant. Themedical assistant types the answers to the questions using keyboard 116.Once the preliminary questions have been answered they are sent viaprinter 42 for review by the patient. Thereafter, the patient signs thepaper copy and transmits it to station 100 using facsimile 44.

At this point, the patient is interviewed by a nurse or other medicalassistant. This interview normally includes the collection of vitalsigns using blood pressure monitor 46, thermometer 48, and heart ratemonitor 50. Thereafter, the patient is interviewed and diagnosed by themedical practitioner. Immediately prior to the end of the session thepatient is sent via facsimile 44, a statement of the charges associatedwith the diagnosis and a prescription statement for any medicationsprescribed by the practitioner.

Several examples of the use of the present system have been given andsuggested in the foregoing description. However, additional exampleswill be given below.

EXAMPLE 1

A patent with arthritis has seen a doctor and been given a prescriptionfor a pain reliever. The patient wants to have the prescriptionrefilled. The patent goes directly to a pharmacy equipped with thepresent invention where he contacts the doctor's office. The nurse atthat office asks the patient routine questions to obtain the answers thedoctor would need in order to authorize a refill of the prescription.The new prescription is sent to the patient by facsimile and he fills itat the pharmacy.

EXAMPLE 2

A medical specialist with a national reputation and living west ofDenver at his home equipped with the present invention, is contacted bya small clinic in rural Montana. The doctor examines the patient inaccordance with the present invention and recommends a course oftreatment to the patient and his attending physician.

EXAMPLE 3

A parent takes a sick child to a kiosk at a nearby shopping area late ona Saturday night. A physician on duty at a hospital in the area examinesthe child according to the present invention and recommends an interimcourse of treatment for the child until regular business hours for thechild's pediatrician resume Monday. A copy of the record of theexamination and the diagnosis and treatment are sent by facsimile to thepediatrician.

EXAMPLE 4

A doctors' group in a rural state set up kiosks with patient's stationsin a large number of small rural towns where that are underserved bymedical practitioners. Local residents go to the kiosks for examinationaccording to the present invention and, only when warranted, travel tothe practitioner's location if additional diagnosis and treatment isneeded. Some of the kiosks are manned by nurses who can facilitate theexaminations and give injections, treat minor burns, draw blood, etc.

It will be apparent to those skilled in the art that many modificationsand substitutions can be made to the preferred embodiment just describedwithout departing from the spirit and scope of the invention as definedin the appended claims.

What is claimed is:
 1. A system for examination of a patient by amedical practitioner comprising:a first station; a second station spacedapart from said first station; first communicating means in said firststation; second communicating means in said second station; means forconnecting said first and said second communicating means so that saidpatient and said practitioner can transfer information between saidfirst and said second stations when said patient is at said firststation and said practitioner is at said second station; means carriedby said first station for verifying the identity of said patient; andmeans carried by said first station for establishing a mode of paymentfor said examination, wherein said first station is operated by aretailer and wherein said patient has an account number issued by saidretailer and wherein said establishing means further comprises meanscarried by said second station for billing said retailer under saidaccount number.
 2. The system as recited in claim 1, further comprisingmeans carried by said first station for measuring the blood pressure ofsaid patient, said blood pressure measuring means being in electricalconnection with said connecting means.
 3. The system as recited in claim1, further comprising means carried by said first station for measuringthe temperature of said patient, said temperature measuring means beingin electrical connection with said connecting means.
 4. The system asrecited in claim 1, further comprising means carried by said firststation for measuring the heart rate of said patient, said heart ratemeasuring means being in electrical connection with said connectingmeans.
 5. The system as recited in claim 1, wherein said verifying meansfurther comprises means carried by said first station for generating animage of at least one identification card, said generating means beingin electrical connection with said connecting means.
 6. The system asrecited in claim 1, wherein said verifying means further comprises:aframe mounted in said first station, said frame dimensioned to receiveat least one identification card carried by said patient; a video cameracarried by said first station, said video camera producing a video imageof said at least one identification card; and means for converting saidvideo image to a still image, said converting means being in electricalconnection with said connecting means.
 7. The system as recited in claim1, wherein said establishing means further comprises:means carried bysaid first station for accepting a credit card, said accepting meansbeing in electrical connection with said connecting means; and anelectronic signature device carried by said first station, saidelectronic signature device being in electrical connection with saidconnecting means.
 8. The system as recited in claim 1, wherein saidfirst communicating means further comprises first means for generatingvideo images and first means for receiving video images, said firstmeans for receiving and said first means for generating being inelectrical connection with said connecting means, and wherein saidsecond communicating means further comprises a second means forgenerating video images and a second means for receiving video images,said second means for generating and said second means for receivingbeing in electrical connection with said connecting means so that saidpatient and said practitioner can transfer video images between themwhen said patient is at said first station and said practitioner is atsaid second station.
 9. A system for examination of a patient by amedical practitioner comprising:a first station; a second station spacedapart from said first station; first communicating means in said firststation; second communicating means in said second station; means forconnecting said first and said second communicating means so that saidpatient and said practitioner can transfer medical information betweensaid first and second stations when said patient is at said firststation and said practitioner is at said second station; means carriedby said first station for generating an image of at least oneidentification card carried by said patient, said generating means beingin electrical connection with said connecting means; and means carriedby said first station for accepting a credit card, said accepting meansbeing in electrical connection with said connecting means; and anelectronic signature device carried by said first station, saidelectronic signature device being in electrical connection with saidconnecting means, wherein said first station is operated by a retailerand wherein said patient has an account number issued by said retailerand wherein said establishing means further comprises means carried bysaid second station for billing said retailer under said account number.10. The system as recited in claim 9, further comprising:means carriedby said first station for measuring the temperature of said patient,said temperature measuring means being in electrical connection withsaid connecting means; and means carried by said first station formeasuring the blood pressure of said patient, said blood pressuremeasuring means being in electrical connection with said connectingmeans.
 11. The system as recited in claim 9, further comprising meanscarried by said first station for measuring the heart rate of saidpatient, said heart rate measuring means being in electrical connectionwith said connecting means.
 12. The system as recited in claim 9,wherein said generating means further comprises:a frame mounted in saidfirst station, said frame dimensioned to receive at least oneidentification card carried by said patient; a video camera carried bysaid first station, said video camera producing a video image of said atleast one identification card; and means for converting said video imageto a still image, said converting means being in electrical connectionwith said connecting means.
 13. The system as recited in claim 9,wherein said first communicating means further comprises first means forgenerating video images and first means for receiving video images, saidfirst means for receiving and said first means for generating being inelectrical connection with said connecting means, and wherein saidsecond communicating means further comprises a second means forgenerating video images and a second means for receiving video images,said second means for generating and said second means for receivingbeing in electrical connection with said connecting means so that saidpatient and said practitioner can transfer video images between themwhen said patient is in said first station and said practitioner is insaid second station.